How much rates vary
Facilitymedian $389 · 10th to 90th $102 to $3,802Professionalmedian $170 · 10th to 90th $105 to $257
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $128.82 Median $309.03 Typical High $8,317.64 | Facility | None | $128.82 | $309.03 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $309.03 | Professional | None | $102.33 | $173.78 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,698.24 | $2,398.83 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $229.09 | Professional | None | $104.71 | $154.88 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $138.04 | Professional | None | $104.71 | $117.49 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $134.90 Typical High $251.19 | Facility | None | $50.12 | $134.90 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $275.42 | Professional | None | $109.65 | $177.83 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $269.15 | Professional | None | $169.82 | $223.87 | $269.15 |
Medcost Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $269.15 | Professional | None | $190.55 | $190.55 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $104.71 Median $173.78 Typical High $346.74 | Facility | None | $104.71 | $173.78 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $102.33 Median $371.54 Typical High $2,454.71 | Facility | None | $102.33 | $371.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $1,071.52 | Professional | None | $128.82 | $245.47 | $1,071.52 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $295.12 | Professional | None | $102.33 | $177.83 | $295.12 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $70.79 Typical High $89.13 | Professional | 52 · Reduced service | $51.29 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.84 Typical High $36.31 | Professional | 53 · Discontinued | $20.42 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $107.15 Typical High $134.90 | Professional | 54 · Surgery only | $77.62 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $21.38 Typical High $26.92 | Professional | 55 · Aftercare only | $15.49 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.13 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.23 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $100.00 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $72.44 | $100.00 | $125.89 |
Where Virginia sits
The same service costs 3.5 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 42nd of 51
$174
AK $490FL $138
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.